<div class="content login-box">
	<div class="login-main">
		<div class="wrap need-add-after-bg pdt-bt-10">
			<h1>TẠO TÀI KHOẢN</h1>
			<div id="flg_message" class="alert hidden">
				<h4 class="message-title"></h4>
				<p class="message-text"></p>
			</div>
			<div class="register-grids">
				<form id="frm-signup" method="post" action="<?php echo page_url('dang-ki/do'); ?>">
					<div class="register-top-grid">
						<h3>THÔNG TIN CÁ NHÂN</h3>
						<div>
							<span>Họ tên<label>*</label></span>
							<input type="text" maxlength="50" name="signup[full_name]" id="full_name" />
						</div>
						<div>
							<span>Email<label>*</label></span>
							<input type="text" maxlength="150" name="signup[email]" id="email" />
						</div>
						<div class="clear"> </div>
					</div>
					<div class="clear"> </div>
					<div class="register-bottom-grid">
						<h3>THÔNG TIN ĐĂNG NHẬP</h3>
						<div>
							<span>Tên đăng nhập<label>*</label></span>
							<input type="text" maxlength="50" name="signup[username]" id="username" />
						</div>
						<div>
							<span>Mật khẩu<label>*</label></span>
							<input type="password" maxlength="100" name="signup[password]" id="password" />
						</div>
						<div>
							<span>Xác nhận mật khẩu<label>*</label></span>
							<input type="password" maxlength="100" name="repassword" id="repassword" />
						</div>
						<div class="clear"> </div>
					</div>
					<div class="clear"> </div>
					<button type="button" id="btn-signup" class="btn"><i class="glyphicon glyphicon-ok-sign"></i> Xác nhận</button>
				</form>
			</div>
		</div>
	</div>
</div>